A prospective randomised controlled trial of nutritional supplementation in malnourished elderly in the community: clinical and health economic outcomes

Edington, J; Barnes, R; Bryan, F.; Dupree, E; Frost, Gary; Hickson, Mary; Lancaster, Jeffrey; Mongia, Sarika; Smith, J. C.; Torrance, A.; West, R; Pang, Francis; Coles, Stephen J.

doi:10.1016/s0261-5614(03)00107-9

Cited by 107 publications

(94 citation statements)

References 13 publications

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“…Malnutrition needs to be identified and treated effectively, since failure to do so can lead to disease complications and delay recovery from illness, at Elderly hospital discharges (49) Hip fracture hospital discharges (51) Elderly hospital discharges (50) Elderly hospital discharges (47) Benign GI disease (48) Elderly community (52) Routine care ONS % admitted to hospital * * Fig. 3.…”

Section: Resultsmentioning

confidence: 99%

“…Recently, two large RCT have highlighted significant reductions in hospital readmissions following the use of ONS in community settings, in older people with a wide range of conditions and in individuals with benign gastrointestinal disease (46,47) . Other trials have also shown lower (not significantly so) hospital admissions/readmissions with the use of ONS v. routine care (48)(49)(50)(51) (Fig. 3).…”

Section: Proceedings Of the Nutrition Societymentioning

confidence: 99%

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Encouraging appropriate, evidence-based use of oral nutritional supplements

Stratton

Elia

2010

Proc. Nutr. Soc.

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With the considerable cost of disease-related malnutrition to individuals and to society (estimated to be > £13 · 10 9 for the UK, 2007 prices), there is a need for effective and evidence-based ways of preventing and treating this condition. The wide range of oral nutritional supplements that may be prescribed for the dietary management of malnutrition and other conditions account for only about 1 % (about £99 · 10 6 , 2007 data) of the prescribing budget in England. Systematic reviews and meta-analyses consistently suggest that ready-made, multinutrient liquids which may be prescribed can improve energy and nutritional intake, body weight and have a variety of clinical and functional benefits in a number of patient groups. Meta-analyses have repeatedly shown that oral nutritional supplements produce significant reductions in complications (e.g. infections) and mortality, and a recent meta-analysis shows a reduction in hospital admissions (OR 0 . 56 (95% CI 0 . 41, 0 . 77), six randomised controlled trials). Such benefits suggest that the appropriate use of oral nutritional supplements should form an integral part of the management of malnutrition, particularly as there is currently a lack of evidence for alternative oral nutrition strategies (e.g. food fortification and counselling). As with all therapies, compliance to oral nutritional supplements needs to be maximised and the use monitored. To make sure that those at risk of malnutrition are identified and treated appropriately, there is a need to embed national and local policies into routine clinical practice. In doing so, the economic burden of this costly condition can be curtailed. As recently suggested by the National Institute for Health and Clinical Excellence, substantial cost savings could be made if screening and treatment of malnourished patients was undertaken.

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Section: Resultsmentioning

confidence: 99%

Section: Proceedings Of the Nutrition Societymentioning

confidence: 99%

Encouraging appropriate, evidence-based use of oral nutritional supplements

Stratton

Elia

2010

Proc. Nutr. Soc.

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“…The studies showed that being undernourished in COPD is likely to be associated with longer in-patient hospital stays [107,108], a higher probability of being readmitted [62,109] and an increase in healthcare utilisation [110] in comparison with normally nourished patients. Three randomised controlled trials in COPD investigated the effects of nutritional supplementation on healthcare utilisation and/or costs [65,76,111]. Two studies did not find a difference in hospital admissions.…”

Section: Cost-effectiveness Issuesmentioning

confidence: 99%

Nutritional assessment and therapy in COPD: a European Respiratory Society statement

et al. 2014

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Nutrition and metabolism have been the topic of extensive scientific research in chronic obstructive pulmonary disease (COPD) but clinical awareness of the impact dietary habits, nutritional status and nutritional interventions may have on COPD incidence, progression and outcome is limited. A multidisciplinary Task Force was created by the European Respiratory Society to deliver a summary of the evidence and description of current practice in nutritional assessment and therapy in COPD, and to provide directions for future research. Task Force members conducted focused reviews of the literature on relevant topics, advised by a methodologist. It is well established that nutritional status, and in particular abnormal body composition, is an important independent determinant of COPD outcome. The Task Force identified different metabolic phenotypes of COPD as a basis for nutritional risk profile assessment that is useful in clinical trial design and patient counselling. Nutritional intervention is probably effective in undernourished patients and probably most when combined with an exercise programme. Providing evidence of costeffectiveness of nutritional intervention is required to support reimbursement and thus increase access to nutritional intervention. Overall, the evidence indicates that a well-balanced diet is beneficial to all COPD patients, not only for its potential pulmonary benefits, but also for its proven benefits in metabolic and cardiovascular risk. @ERSpublications Metabolism and nutrition: shifting paradigms in COPD management

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“…В исследованиях показано, что больные ХОБЛ с дефицитом МТ с высокой вероятностью будут дольше находиться в стационаре [107,108], чаще госпитализироваться повторно [62,109] и использо вать больше ресурсов здравоохранения [110] по срав нению с больными ХОБЛ с нормальной МТ. Влия ние пищевых добавок на потребность в ресурсах здравоохранения и / или стоимость лечения ХОБЛ изучалось в 3 рандомизированных контролируемых исследованиях [65,76,111]. В 2 из них не выявлено разницы в частоте госпитализаций, хотя весьма ве роятно, что в этих исследованиях длительность наб людения (≤ 6 мес.)…”

Section: клинические рекомендацииunclassified

Evaluation of nutritional status and nutritional therapy in chronic obstructive pulmonary disease

Редакционная¹

2016

Pulʹmonologiâ (Mosk.)

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A prospective randomised controlled trial of nutritional supplementation in malnourished elderly in the community: clinical and health economic outcomes

Cited by 107 publications

References 13 publications

Encouraging appropriate, evidence-based use of oral nutritional supplements

Encouraging appropriate, evidence-based use of oral nutritional supplements

Nutritional assessment and therapy in COPD: a European Respiratory Society statement

Evaluation of nutritional status and nutritional therapy in chronic obstructive pulmonary disease

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